Right-sided versus left-sided colorectal cancer in elderly patients: a sub-analysis of a large multicenter case–control study in Japan

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2024年6月5日

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Haruki Sada,
Takao Hinoi,
Hiroaki Niitsu,
Hideki Ohdan,
Seiichiro Yamamoto,
Shungo Endo,
Koya Hida,
Yusuke Kinugasa,
Toshiyuki Enomoto,
Satoshi Maruyama,
Fumio Konishi,
Masahiko Watanabe,
Eiji Kanehira,
Kunihisa Shiozawa,
Hiroyuki Bando,
Daisuke Yamamoto,
Seigo Kitano,
Masafumi Inomata,
Tomonori Akagi,
Junji Okuda,
Keitaro Tanaka,
Masayoshi Yasui,
Kosei Hirakawa,
Kiyoshi Maeda,
Akiyoshi Kanazawa,
Junichi Hasegawa,
Junichi Nishimura,
Shintaro Akamoto,
Masashi Ueno,
Hiroya Kuroyanagi,
Masaki Naito,
Takashi Ueki,
Yoshiharu Sakai,
Koya Hida,
Yousuke Kinjo,
Yukihito Kokuba,
Madoka Hamada,
Norio Saito,
Masaaki Ito,
Shigeki Yamaguchi,
Jou Tashiro,
Toshimasa Yatsuoka,
Tomohisa Furuhata,
Kenji Okita,
Yoshiro Kubo,
Shuji Saito,
Yosuke Kinugasa,
Fumio Konishi,
Kazuhiro Sakamoto,
Michitoshi Goto,
Junichi Tanaka,
Nobuyoshi Miyajima,
Tadashi Suda,
Tsukasa Shimamura,
Yoshihisa Saida,
Toshiyuki Enomoto,
Takeshi Naito,
Yasuhiro Munakata,
Ken Hayashi,
Yasukimi Takii,
Satoshi Maruyama,
Yohei Kurose,
Yasuhiro Miyake,
Shoichi Hazama,
Shoich Fujii,
Shigeru Yamagishi,
Masazumi Okajima,
Seiichiro Yamamoto,
Hisanaga Horie,
Kohei Murata,
Kenichi Sugihara

摘要

Purpose

This study investigated the impact of sidedness of colorectal cancer (CRC) in elderly patients on the prognosis.

Methods

In a sub-analysis of a multicenter case–control study of CRC patients who underwent surgery at ≥ 80 years old conducted in Japan between 2003 and 2007, both short- and long-term outcomes were compared between right-sided colon cancers (RCCs) and left-sided colorectal cancers (LCCs). RCCs were defined as those located from the cecum to the transverse colon.

Results

Among the 1680 patients who underwent curative surgery, 812 and 868 had RCCs and LCCs, respectively. RCCs were more frequent than LCCs in those who were female, had renal comorbidities, and had a history of abdominal surgery. Regarding tumor characteristics, RCCs were larger, invaded more deeply, and were diagnosed as either mucinous or signet ring-cell carcinoma more frequently than LCCs. Regarding the prognosis, patients with RCCs had a significantly longer cancer-specific survival (CS-S) and cancer-specific relapse-free survival (CS-RFS) than those with LCCs. Furthermore, sidedness was determined to be an independent prognostic factor for CS-S and CS-RFS.

Conclusion

RCCs, which accounted for half of the cases in patients ≥ 80 years old, showed better long-term outcomes than LCCs.